摘要
目的探讨吉非替尼敏感与耐药非小细胞肺癌(NSCLC)患者miR-200c、miR-19a、miR-155表达差异,并分析miR-200c、miR-19a、miR-155表达差异对患者预后的影响。方法选取2015年8月1日至2019年8月1日南京医科大学第四附属医院采用吉非替尼治疗的80例Ⅲ~Ⅳ期NSCLC患者作为研究对象,其中吉非替尼敏感患者36例,作为敏感组,吉非替尼耐药患者44例,作为耐药组。比较两组患者一般资料、血清miR-200c、miR-19a、miR-155水平,探究NSCLC患者吉非替尼敏感影响因素及血清miR-200c、miR-19a、miR-155与NSCLC患者临床病理特征的相关性。分析患者生存情况。结果与耐药组比较,敏感组患者吸烟例数较少(χ^(2)=5.541,P=0.019)、临床分期Ⅲ期例数较多(χ^(2)=8.984,P=0.003)、分化程度高分化例数较多(χ^(2)=8.673,P=0.003)、淋巴结转移例数较少(χ^(2)=6.082,P=0.014)、血清miR-200c、miR-19a、miR-155水平均较高(t=7.249,P<0.001;t=8.222,P<0.001;t=10.467,P<0.001)。多因素logistic回归分析显示,吸烟(OR=0.355,95%CI为0.149~0.845,P<0.001)、临床分期(OR=0.494,95%CI为0.274~0.892,P=0.021)、分化程度(OR=6.062,95%CI为3.258~11.279,P=0.013)、淋巴结转移(OR=0.422,95%CI为0.245~0.726,P=0.019)、血清miR-200c(OR=5.521,95%CI为3.126~9.752,P<0.001)、miR-19a(OR=5.384,95%CI为2.947~9.836,P<0.001)、miR-155(OR=5.325,95%CI为3.058~9.274,P<0.001)水平均为NSCLC患者吉非替尼敏感的影响因素。血清miR-200c、miR-19a、miR-155水平与NSCLC患者临床分期(t=3.230,P=0.002,r=-0.578;t=3.188,P=0.002,r=-0.612;t=3.123,P=0.003,r=-0.594)、分化程度(t=2.586,P=0.012,r=0.610;t=4.009,P<0.001,r=0.632;t=4.773,P<0.001,r=0.594)、淋巴结转移(t=2.902,P=0.005,r=-0.587;t=3.721,P<0.001,r=-0.629;t=3.391,P=0.001,r=-0.614)均显著相关。与miR-200c、miR-19a、miR-155低水平患者比较,miR-200c(63.19%vs.4.37%,χ^(2)=32.562,P<0.001)、miR-19a(61.01%vs.4.75%,χ^(2)=37.807,P<0.001)以及miR-155(57.82%vs.0,χ^(2)=44.454,P<0.001)高水平患者1年生存率均较高
Objective To investigate the expression differences of miR-200c,miR-19a and miR-155 in gefitinib sensitive and resistant non-small cell lung cancer(NSCLC)patients,and to analyze the effects of miR-200c,miR-19a and miR-155 expression differences on the prognosis of patients.Methods From August 1,2015 to August 1,2019,80 patients with stageⅢ-ⅣNSCLC who were treated with gefitinib in the Fourth Affiliated Hospital of Nanjing Medical University were selected as the research objects.Among them,36 cases were sensitive to gefitinib as the sensitive group,and 44 cases were resistant to gefitinib as the drug-resistant group.The general data,serum levels of miR-200c,miR-19a and miR-155 were compared between the two groups,and the sensitive factors of gefitinib in NSCLC patients and the correlations between serum miR-200c,miR-19a,miR-155 and clinicopathological characteristics of NSCLC patients were explored.The survival of the patients was analyzed.Results Compared with the drug-resistant group,the number of smoking cases in the sensitive group was less(χ^(2)=5.541,P=0.019),the number of clinical stageⅢcases was more(χ^(2)=8.984,P=0.003),the number of well-differentiated cases was more(χ^(2)=8.673,P=0.003),the number of patients with lymph node metastasis was less(χ^(2)=6.082,P=0.014),and the levels of serum miR-200c,miR-19a and miR-155 were higher(t=7.249,P<0.001;t=8.222,P<0.001;t=10.467,P<0.001).Multivariate logistic regression analysis showed that smoking(OR=0.355,95%CI:0.149-0.845,P<0.001),clinical stage(OR=0.494,95%CI:0.274-0.892,P=0.021),degree of differentiation(OR=6.062,95%CI:3.258-11.279,P=0.013),lymph node metastasis(OR=0.422,95%CI:0.245-0.726,P=0.019),the levels of serum miR-200c(OR=5.521,95%CI:3.126-9.752,P<0.001),miR-19a(OR=5.384,95%CI:2.947-9.836,P<0.001)and miR-155(OR=5.325,95%CI:3.058-9.274,P<0.001)were all influencing factors of gefitinib sensitivity in NSCLC patients.The levels of serum miR-200c,miR-19a and miR-155 were significantly correlated with clinical stage(t=3.230,P=0.002,r=-0.578;t=3.18
作者
刘佩
蒲嘉泽
黄雯
汪斐
Liu Pei;Pu Jiaze;Huang Wen;Wang Fei(Department of Oncology,Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,China)
出处
《国际肿瘤学杂志》
CAS
2021年第7期409-414,共6页
Journal of International Oncology
基金
南京市卫生科技发展专项资金(YKK19149)。
关键词
癌
非小细胞肺
微RNAS
吉非替尼
敏感
耐药
Carcinoma
non-small-cell lung
MicroRNAs
Gefitinib
Sensitive
Drug resistance
